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Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery

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Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery. / Trepte, C J C; Eichhorn, V; Haas, S A; Stahl, K; Schmid, F; Nitzschke, R; Goetz, A E; Reuter, D A.

in: BRIT J ANAESTH, Jahrgang 111, Nr. 5, 01.11.2013, S. 736-42.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Trepte, CJC, Eichhorn, V, Haas, SA, Stahl, K, Schmid, F, Nitzschke, R, Goetz, AE & Reuter, DA 2013, 'Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery', BRIT J ANAESTH, Jg. 111, Nr. 5, S. 736-42. https://doi.org/10.1093/bja/aet204

APA

Trepte, C. J. C., Eichhorn, V., Haas, S. A., Stahl, K., Schmid, F., Nitzschke, R., Goetz, A. E., & Reuter, D. A. (2013). Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery. BRIT J ANAESTH, 111(5), 736-42. https://doi.org/10.1093/bja/aet204

Vancouver

Trepte CJC, Eichhorn V, Haas SA, Stahl K, Schmid F, Nitzschke R et al. Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery. BRIT J ANAESTH. 2013 Nov 1;111(5):736-42. https://doi.org/10.1093/bja/aet204

Bibtex

@article{4964d5cd99614e0d91575609027e57ad,
title = "Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery",
abstract = "BACKGROUND: Predicting the response of cardiac output to volume administration remains an ongoing clinical challenge. The objective of our study was to compare the ability to predict volume responsiveness of various functional measures of cardiac preload. These included pulse pressure variation (PPV), stroke volume variation (SVV), and the recently launched automated respiratory systolic variation test (RSVT) in patients after major surgery.METHODS: In this prospective study, 24 mechanically ventilated patients after major surgery were enrolled. Three consecutive volume loading steps consisting of 300 ml 6% hydroxyethylstarch 130/0.4 were performed and cardiac index (CI) was assessed by transpulmonary thermodilution. Volume responsiveness was considered as positive if CI increased by >10%.RESULTS: In total 72 volume loading steps were analysed, of which 41 showed a positive volume response. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.70 for PPV, 0.72 for SVV and 0.77 for RSVT. Areas under the curves of all variables did not differ significantly from each other (P>0.05). Suggested cut-off values were 9.9% for SVV, 10.1% for PPV, and 19.7° for RSVT as calculated by the Youden Index.CONCLUSION: In predicting fluid responsiveness the new automated RSVT appears to be as accurate as established dynamic indicators of preload PPV and SVV in patients after major surgery. The automated RSVT is clinically easy to use and may be useful in guiding fluid therapy in ventilated patients.",
keywords = "Adult, Aged, Aged, 80 and over, Airway Resistance, Algorithms, Anesthesia, General, Arterial Pressure, Automation, Blood Pressure, Cardiac Output, Female, Fluid Therapy, Humans, Male, Middle Aged, Monitoring, Physiologic, Postoperative Care, Postoperative Period, Predictive Value of Tests, Prospective Studies, ROC Curve, Respiratory Mechanics, Stroke Volume, Thermodilution, Young Adult",
author = "Trepte, {C J C} and V Eichhorn and Haas, {S A} and K Stahl and F Schmid and R Nitzschke and Goetz, {A E} and Reuter, {D A}",
year = "2013",
month = nov,
day = "1",
doi = "10.1093/bja/aet204",
language = "English",
volume = "111",
pages = "736--42",
journal = "BRIT J ANAESTH",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "5",

}

RIS

TY - JOUR

T1 - Comparison of an automated respiratory systolic variation test with dynamic preload indicators to predict fluid responsiveness after major surgery

AU - Trepte, C J C

AU - Eichhorn, V

AU - Haas, S A

AU - Stahl, K

AU - Schmid, F

AU - Nitzschke, R

AU - Goetz, A E

AU - Reuter, D A

PY - 2013/11/1

Y1 - 2013/11/1

N2 - BACKGROUND: Predicting the response of cardiac output to volume administration remains an ongoing clinical challenge. The objective of our study was to compare the ability to predict volume responsiveness of various functional measures of cardiac preload. These included pulse pressure variation (PPV), stroke volume variation (SVV), and the recently launched automated respiratory systolic variation test (RSVT) in patients after major surgery.METHODS: In this prospective study, 24 mechanically ventilated patients after major surgery were enrolled. Three consecutive volume loading steps consisting of 300 ml 6% hydroxyethylstarch 130/0.4 were performed and cardiac index (CI) was assessed by transpulmonary thermodilution. Volume responsiveness was considered as positive if CI increased by >10%.RESULTS: In total 72 volume loading steps were analysed, of which 41 showed a positive volume response. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.70 for PPV, 0.72 for SVV and 0.77 for RSVT. Areas under the curves of all variables did not differ significantly from each other (P>0.05). Suggested cut-off values were 9.9% for SVV, 10.1% for PPV, and 19.7° for RSVT as calculated by the Youden Index.CONCLUSION: In predicting fluid responsiveness the new automated RSVT appears to be as accurate as established dynamic indicators of preload PPV and SVV in patients after major surgery. The automated RSVT is clinically easy to use and may be useful in guiding fluid therapy in ventilated patients.

AB - BACKGROUND: Predicting the response of cardiac output to volume administration remains an ongoing clinical challenge. The objective of our study was to compare the ability to predict volume responsiveness of various functional measures of cardiac preload. These included pulse pressure variation (PPV), stroke volume variation (SVV), and the recently launched automated respiratory systolic variation test (RSVT) in patients after major surgery.METHODS: In this prospective study, 24 mechanically ventilated patients after major surgery were enrolled. Three consecutive volume loading steps consisting of 300 ml 6% hydroxyethylstarch 130/0.4 were performed and cardiac index (CI) was assessed by transpulmonary thermodilution. Volume responsiveness was considered as positive if CI increased by >10%.RESULTS: In total 72 volume loading steps were analysed, of which 41 showed a positive volume response. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.70 for PPV, 0.72 for SVV and 0.77 for RSVT. Areas under the curves of all variables did not differ significantly from each other (P>0.05). Suggested cut-off values were 9.9% for SVV, 10.1% for PPV, and 19.7° for RSVT as calculated by the Youden Index.CONCLUSION: In predicting fluid responsiveness the new automated RSVT appears to be as accurate as established dynamic indicators of preload PPV and SVV in patients after major surgery. The automated RSVT is clinically easy to use and may be useful in guiding fluid therapy in ventilated patients.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Airway Resistance

KW - Algorithms

KW - Anesthesia, General

KW - Arterial Pressure

KW - Automation

KW - Blood Pressure

KW - Cardiac Output

KW - Female

KW - Fluid Therapy

KW - Humans

KW - Male

KW - Middle Aged

KW - Monitoring, Physiologic

KW - Postoperative Care

KW - Postoperative Period

KW - Predictive Value of Tests

KW - Prospective Studies

KW - ROC Curve

KW - Respiratory Mechanics

KW - Stroke Volume

KW - Thermodilution

KW - Young Adult

U2 - 10.1093/bja/aet204

DO - 10.1093/bja/aet204

M3 - SCORING: Journal article

C2 - 23811425

VL - 111

SP - 736

EP - 742

JO - BRIT J ANAESTH

JF - BRIT J ANAESTH

SN - 0007-0912

IS - 5

ER -